Ready to deprescribe? Assessing student knowledge and confidence to deprescribe: a cross-sectional study

Abstract Introduction Deprescribing can be defined as the systematic process of identifying and discontinuing medicines when harms outweigh benefits within the context of an individual patient’s care goals, level of functioning, life expectancy, values, and preferences.[1] Pharmacists, as medicines experts, can play a crucial role in deprescribing consultations 1–1 with patients and as part of interdisciplinary teams. Introducing deprescribing into educational curricula early is advantageous to their knowledge and confidence development.[2] Aim This study aimed to explore students’ perceptions of deprescribing education across the four stages of the MPharm programme and assess their confidence to deprescribe. Method A cross-sectional study was conducted in 2023 and 2024, shared with 732 and 564 students respectively (total 1296). Data were collected via an anonymised electronic survey deployed to students on an MPharm programme via stage leads to explore deprescribing knowledge of/confidence to deprescribe. Both quantitative and qualitative responses were captured. The survey consisted of 12 questions including open and closed questions. Questions focused on knowledge of the deprescribing process, confidence to deprescribe, knowledge of tools and programme improvement recommendations to better support deprescribing readiness. Quantitative data were analysed using descriptive statistics. Recurring language and opinions were identified, and open-ended questions were categorised based on differing themes. Results A total of 40 MPharm students participated in the 2023 survey, and 56 students responded in 2024 (response rates of 6.2% and 11.8% respectively). Familiarity with the concept of deprescribing varied, with 67% (27) of students in 2023 reporting prior awareness compared to 86% (48) in 2024. Self-assessed readiness to deprescribe had a mean score of 2.38 (40) in 2023 to 2.75 (55) in 2024 on a five-point scale. Overall confidence of pharmacy students to deliver deprescribing consultations ranged from 60% (24) (2023) to 48% (27) (2024). Thematic analysis of open responses revealed the complexity of the deprescribing practice and the need for more simulated and placement opportunities. Experiential learning was reported as insufficient, with only 28% (11) of students in 2023 and 39% (22) in 2024 indicating they had placement experience involving deprescribing consultations. Most students expressed a desire for curriculum enhancement (83%, 33 in 2023 and 75%, 42, in 2024) to better support deprescribing education. The optimal point to fully explore deprescribing in the curriculum varied but stage 3 was considered most appropriate (30%, 29). Conclusion Students were aware of the concept of deprescribing and appreciated its importance in professional practice. More practical exposure through case analysis, simulations, placements and OSCEs is sought to deepen their knowledge and confidence in deprescribing. Students anticipate complexity in deprescribing consultations. Increased provision of authentic experiential learning can help navigate future challenging situations to deprescribe safely and competently to improve health. This study examines an underexplored aspect of pharmacy practice education. This study is exploratory reporting on two academic years. Small sample sizes and low response rates limit representativeness; findings should be interpreted with due consideration and further refinement is required. Future research will involve deprescribing mapping across the MPharm programme and self-efficacy evaluation per stage and comprehensively.